Medical Bulletin Board

Obesity Harms 'Later Brain Skill'

2013-02-18T10:00:00.000-05:00

A Korean study suggests that being obese at a later stage in life increases one’s chances of having a brain decline. The study was done on 250 people between the age group of 60 and 70 with a high BMI or Body Mass Index. The seniors scored poor marks in cognitive tests. The research was published in the journal Age and Ageing.

The study has successfully established the connection between an excess of body fat and brain function. It also pointed out that lifestyle changes could help make a big difference in the brain function.

The participants of the study underwent BMI calculation, scan of fat stored in the abdomen, mental test and waist circumference measurements. The results showed that high BMI and high levels of BMI was linked to poor cognitive performances in the adults, who were aged between 60 and 70. In individuals above 70, a high level of any of the three factors had no link to cognitive performance.

The researchers expressed a lack of information with regards to the participants developing dementia, but are sure of the fat’s contribution to brain decline. The doctors, who helped conduct the study, said that the impact of weight on the head can be kept in control or at bay by way of exercising regularly, checking blood pressure constantly and checking the cholesterol levels in the body.

As per several researches, at least one in three people over 65 die of dementia though there are things that a person can do to avoid the risk of developing it. The research also indentified the prevention of possible cognitive decline or even dementia by preventing obesity, particularly central obesity.

When Doctors Feel Pain After a Medical Mistake

2013-02-18T09:30:00.000-05:00

Dr. David Ring, an associate professor at Harvard Medical School and board certified orthopedic and hand surgeon, once performed the wrong surgery on a patient’s finger. Ring quickly noticed and fixed his mistake, but it was one of the worst experiences of his life, he told ProPublica reporter Marshall Allen in a 2011 interview.

Sometimes doctors or nurses who cause harm to a patient are the perpetrators: They’re careless, negligent, taking on too many cases because they’re greedy, sloppy or incompetent. But often this is not the case. A well-meaning, expertly-trained provider makes an honest error and feels deep remorse.

Plus, there are often extenuating circumstances that contribute to the mistake. In Ring’s case, a series of events contributed to confusion in the operating room that day. As Allen noted:

• The nurse marked the correct arm, but not the incision site.

• Surgeons were behind schedule, so people were stressed.

• The nurse who prepped the patient for surgery wasn’t present for the procedure, because the patient had been moved to a different operating room.

• The nursing team changed in the middle of the procedure.

In these cases, health care providers, like Ring, are sometimes called the “second victim” of medical mistakes. The term recognizes that being part of an error also takes an emotional and psychological toll on the provider. According to Susan D. Scott, a registered nurse and patient safety coordinator at the University of Missouri Health Care, providers have described, in published anecdotes, “powerful feelings of guilt, incompetence, or inadequacy:” feelings that can affect performance and, in some cases, have destroyed careers.

Members of ProPublica’s Patient Harm Community have criticized the term “second victim.” Debra Van Putten called it “deeply offensive and insensitive to the patient community.” Bart Windrum said, “I actually almost abhor the phrase “second victim” describing providers. I understand its impetus, it’s just wholly inaccurate because the family members are the 2nd victims. Providers are at best 3rd victims.”

Many providers stay quiet about errors, which complicates the issue. Some fear a ruined reputation. Some are wary of bullying from colleagues. Some feel pressure from hospital lawyers and risk managers not to admit to mistakes.

But Wu is among those who believe that recognizing the phenomenon and changing medicine’s culture of silence could help doctors heal and benefit patients, too.

“If people are consistently beaten up when there's a bad outcome, you create a climate in which no one talks about anything,” Wu told Health Leaders Media’s Cheryl Clark, “and a conspiracy of silence leads to mistakes being repeated."

Brian Goldman, an emergency room physician in Toronto, echoed Wu’s thoughts in a TED talk in November 2011: “If I can’t come true and talk about my mistakes, how can I share it with my colleagues? How can I teach them about what I did, so they don’t do the same thing?”

Doug Wojcieszak, a member of ProPublica’s Patient Harm Community, also believes transparency can help reduce lawsuits over medical errors. Wojcieszak’s brother died after a mistake in 1998. Now, his organization, SorryWorks!,encourages and trains health care professionals to rapidly disclose errors, conduct independent reviews and, if necessary, apologize and negotiate financial compensation with patients outside of the courts. The University of Illinois at Chicago Medical Center has experimented with disclosure as part of a program Allen wrote about three years ago.

Wojcieszak said providers have also told him that disclosure is one of the best ways to aid personal healing and learn from mistakes. “The organizations that are really good at this will tell you that the biggest benefit is patient safety,” he said. “When we own our mistakes, we have a chance to learn.”

Source: www.propublica.org

Good Dental Health Improves Women Conceiving

2013-02-18T09:00:00.001-05:00

An Australian study suggested that women having periodontal disease take longer to conceive than women with healthy oral condition. The study was conducted on 1,956 women who wanted to become pregnant. Out of 1,956 women, 74 per cent were free from oral problems and remaining women had cavities.

The finding of the study was that that women with periodontal problems took longer time, approximately seven months, to conceive whereas women with healthy oral condition took five months to conceive.

Another revelation was effects of oral bacteria that cause cavities. Oral bacteria increase inflammation affecting placental health. In addition, it elevates the risk of miscarriage and premature delivery.

Maintaining good oral health is important for overall health. Some previous studies have shown that people with poor and irregular brushing habits have more chances of suffering from cardiovascular ailments, such as heart attack and stroke.

To avoid risk of developing cavities, intake of sugary food items, such as chocolates, cookies, sweets and cakes must be monitored. Taking green tea, raisins and cranberries may help you to have healthy teeth and gums.

Obesity also increases the risk of periodontal disease, which in turn affects a woman’s fertility. Therefore, efforts must be taken to get rid of extra weight.

Other than maintaining good dental health, some other lifestyle changes can also improve your fertility:

To increase your chances of conception, put an end on intake of sources of caffeine, nicotine, and alcohol. Junk food should also be avoided.

Too little sleep, staying awake until late night disturb your fertility. Sleep for at least seven to nine hours a day.

Over as well as under exercise affects your fertility. For better fertility, maintain healthy weight by following a regular exercise regime. Keep in mind that it is not taxing to your immune system.

Cockroach Allergies Cause Asthma in Kids

2013-02-11T11:00:00.000-05:00

A cockroach allergy is a major contributing factor to asthma in urban children. However, new research is now suggesting that the insect is just a part of a more complex group of factors behind high rates of asthma in an urban environment.

Researchers at the Columbia Center for Children’s Environmental Health at the Mailman School of Public Health suggest that very early exposure to certain components of air pollution can increase the risk of developing a cockroach allergy by age 7 and children with a common mutation in a gene called GSTM may be especially at risk.

"Allergy to cockroach is one of the greatest risk factors for asthma in low-income urban communities. Our findings indicate a complex relationship between allergen and air pollution exposures early in life and a possible underlying genetic susceptibility. Combined, these findings suggest that exposures in the home environment as early as the prenatal period can lead to some children being at much greater risk for developing an allergy to cockroach, which, in turn, heightens their risk of developing asthma,” lead author, Mathew Perzanowski, PhD, was quoted as saying.

Researchers examined 349 mother-child pairs from the Center’s Mothers & Newborns study of environmental exposures in Northern Manhatten and the Bronx. They measured the mother during pregnancy to determine exposure to cockroach allergen. Dust from the kitchen and bed was used to measure the protein in feces, saliva, and other remnants of the cockroach.

The mother’s exposure to polycyclic hydrocarbons (PAH), combustion products that are harmful components of air pollution, was measured through air samples. The presence of the GSTM1 mutation was measured through blood samples. Also, children at ages 5 and 7 had blood tests to identify the presence of IgE antibodies, an immune marker of allergy.

In 279, or 80%, of homes tested positive for high levels of cockroach allergen. At age 7, 82 (30%) of the 264 children that were tested had a cockroach allergy. The higher levels of cockroach allergen led cockroach allergy only in children whose mothers had been exposed to higher levels of PAH during pregnancy. This suggests that PAH enhances their immune response to the allergen.

The combination of the two exposures was even greater in the 27% of children with a common mutation in the GSTM gene, suggesting that minimizing exposure to PAH during pregnancy and to cockroach allergen during early childhood could be helpful in preventing cockroach allergies and asthma in urban areas.

"Asthma among many urban populations in the United States continues to rise. Identifying these complex associations and acting upon them through better medical surveillance and more appropriate public policy may be very important in curtailing this alarming trend,” senior author, Rachel Miller, MD, was quoted as saying.

Practicing Tai Chi Reduces Falls in Stroke Survivors

2013-02-11T10:00:00.000-05:00

Those who suffer from a stroke fall seven times more each year than healthy adults, causing fractures and decreasing mobility. Now, new research is suggesting that the stroke survivors who practice Tai Chi experience less falls when compared to survivors who receive usual care or participate in a national fitness program for Medicare-eligible adults called SilverSneakers.

Tai Chi is an ancient Chinese martial art that includes physical movements, relaxed breathing, and mental concentration. Study participants practiced Yang-style Tai Chi, the most popular of the five styles that are used in the United States because of the emphasis on physical and psychosocial benefits.

"Learning how to find and maintain your balance after a stroke is a challenge. Tai Chi is effective in improving both static and dynamic balance, which is important to prevent falls. Tai Chi is readily available in most U.S. cities and is relatively inexpensive,” Ruth E. Taylor-Piliae, PhD, RN, the study's principal investigator and assistant professor at the University of Arizona College of Nursing in Tucson, AZ, was quoted as saying.

Researchers examined 89 stroke survivors, mostly those who had ischemic strokes on average three years prior to beginning the study, for a randomized prospective study. Study participants were on average 70 years old, 46% were women, most of them were Caucasian, college educated, and lived in the Tucson area.

Out of the 89 participants, 30 practiced Tai Chi, 28 took part in usual care, and 31 did SilverSneakers. The SilverSneakers and Tai Chi groups exercised in a one-hour class three times a week for 12 weeks. The group who just had the usual care received written material and a weekly phone call about participating in community-based physical activity.

During the 12-week trial, 34 reported falls in participants’ homes mostly from tripping or slipping: five falls in the Tai Chi group, 14 falls in the SilverSneakers group, and 15 falls in the usual care group.

"The main physical benefits of Tai Chi are better balance, improved strength, flexibility and aerobic endurance. Psycho-social benefits include less depression, anxiety and stress, and better quality of life,” Taylor-Piliae said.

Sperm Count Lowers as Watching TV Longer

2013-02-11T09:00:00.000-05:00

The correlation between TV and a man’s sperm count is a tricky one. New research suggests that healthy young men who watch TV for more than 20 hours a week have close to half the sperm count of men who watch very little TV, but 15 hours or more a week spent on moderate to vigorous exercise improves it by 73%.

Study authors say that semen quality seems to have deteriorated over the past couple decades and it is not clear why.

To determine if an increasingly sedentary lifestyle might be a contributory factor, the study analyzed the semen quality of 189 men between ages of 18 to 22 in 2009 and 2010 from Rochester, NY.

Study participants were asked about factors that might affect sperm quality, including medical or reproductive health problems, stress levels, smoking, and diet. They were also asked about the quantity and intensity of weekly exercise they had over the preceding three months, how much time they spent watching TV, DVDs, or videos over the same period.

Over half the men were in the normal range for weight and height. Three out of four of them were non-smokers and they had low prevalence reproductive health problems.

The amount of moderate to vigorous exercise every week ranged from 5 to 14 hours, while time spent watching TV varied from 4 to 20 hours. Also, men who were more physical tended to have a healthier diet than those who watched a lot of TV.

The study found that exercise did not affect sperm motility, shape, or sample volume. Light exercise made no difference to the sperm count, no matter how frequent it was.

TV viewing had the opposite effect. For those who watched the most, 20 hours or more a week, had a sperm count that was 44% lower than those who watched the least.

Study authors caution that a reduced sperm count does not exactly curb a man’s fertility or his chances of being able to become a parent. However, the findings do suggest that a more physically active lifestyle may improve semen quality.

“Future studies should also evaluate the extent to which different exercise types affect semen quality as previous studies suggest that there might be opposing effects of different types of activity on semen characteristics,” study authors were quoted as saying.